ORCID Profile
0000-0002-0910-889X
Current Organisation
Azienda Sanitaria dell'Alto Adige
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Publisher: FSBI SRIGR RAMS
Date: 29-04-2021
DOI: 10.15360/1813-9779-2021-2-72-87
Abstract: Patients may experience long-term physical, psychological and cognitive impairment after intensive care unit (ICU) discharge, a condition commonly described as post-intensive care syndrome. The relative contribution of each of these components to long-term quality of life was never investigated. The aim of this study is to identify the type and severity of disability and QoL at the discharge from ICU and up to following 6 months. Material and Methods . All patients ( n =218) discharged from a university hospital ICU between April 2016 and July 2017 were eligible. Exclusion criteria included: age years, brain or spinal injury, life expectancy days, and ICU stay hours. The Short Form Health Survey (SF-36), and 5-level EuroQoL-5D (EQ-5D-5L) questionnaires were administered at ICU discharge, and at 30-, 90- and 180-days. We compared patients requiring short-term ICU monitoring (IM, Intensive Monitoring, n =109) or patients requiring ICU treatment (IT, Intensive Treatment, n =109). Results . All dimensions of SF-36 and EQ-5D-5L parameters increased from ICU discharge to 180-days, except for the SF-36 Synthetic index linked to mental health (P=0.08). All EQ-5D-5L parameters improved significantly in the IT group, while only Visual Analog Scale Health Perception improved in the IM group. Conclusion . ICU survivors suffer long-term physical and psychological sequelae. The perception of Quality of Life is reduced after ICU discharge. The psychological and cognitive dimensions were more compromised than physical ones. Patients discharged from the ICU may benefit from specific intensive care follow-up clinics addressing their needs in term of psychological and cognitive support.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.JCRC.2016.08.010
Abstract: Inotropes and vasopressors are cornerstone of therapy in septic shock, but search for the best agent is ongoing. We aimed to determine which vasoactive drug is associated with the best survival. PubMed, BioMedCentral, Embase, and the Cochrane Central Register were searched. Randomized trials performed in septic patients with at least 1 group allocated to an inotrope/vasopressor were included. Network meta-analysis with a frequentist approach was performed. The 33 included studies randomized 3470 patients to 16 different comparators. As compared with placebo, levosimendan (odds ratio [OR], 0.17, 95% confidence interval [CI], 0.05-0.60), dobutamine (OR, 0.30 95% CI, 0.09-0.99), epinephrine (OR, 0.35 95% CI, 0.13-0.96), vasopressin (OR, 0.37 95% CI, 0.16-0.89), and norepinephrine plus dobutamine (OR, 0.4 95% CI, 0.11-0.96) were significantly associated with survival. Norepinephrine improved survival compared with dopamine (OR, 0.81 95% CI, 0.66-1.00). Rank analysis showed that levosimendan had the highest probability of being the best treatment. Among several regimens for pharmacological cardiovascular support in septic patients, regimens based on inodilators have the highest probability of improve survival.
Publisher: Springer Science and Business Media LLC
Date: 08-03-2021
Publisher: Massachusetts Medical Society
Date: 27-06-2019
No related grants have been discovered for Carlo LEGGIERI.